Glaucoma is an eye disease in which optic nerve damage leads to peripheral vision loss and eventually blurring of central vision. Open angle glaucoma (the most common form in the United States) occurs when microscopic changes in the drain of the eye (the trabecular meshwork) blocks the flow of fluid out of the eye. Elevated eye pressure is a risk factor for open angle glaucoma but up to 30% of patients may have pressure within what is considered the normal range.
In primary angle closure glaucoma, the trabecular meshwork (drain within eye) is physically blocked because the front of the eye is crowded.
The only treatment available for glaucoma is the lowering of eye pressure to reduce the risk of future vision loss. Any vision already lost from glaucoma is permanent.
Some cases of glaucoma can be treated with topical medications. For others, laser or traditional surgery is required to lower eye pressure.
Common procedures include:
- Laser Peripheral Iridotomy (LPI) – For patients with narrow-angle glaucoma. A small hole is made in the iris to increase the angle between the iris and cornea and encourage fluid drainage.
- Argon Laser Trabeculoplasty (ALT) and Selective Laser Trabeculoplasty (SLT) – For patients with open angle glaucoma. Laser energy is applied to the trabecular meshwork which promotes remodeling of the meshwork and increases fluid drainage. SLT is effective in about 80% of patients and may be repeated up to 3-4 times.
- Filtering Microsurgery (Trabeculectomy) – For patients who have not been helped with laser surgery or medications. A new drainage passage is created by cutting a small hole in the sclera (the white part of the eye) and creating a collection pouch between the sclera and conjunctiva (the outer covering of the eye).
- Tube Shunt Surgery – May be recommended for patients with neovascular glaucoma, failed trabeculectomy, or susceptibility to developing scar tissue. A thin, flexible tube (a shunt) with a silicone pouch is inserted in the eye to facilitate drainage.